Claims Examiner for Workers Compensation analyzing and adjudicating complex claims for various jurisdictions. Working in a hybrid model from Plano, TX or remote for experienced professionals.
Responsibilities
Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim;
Manages claims through well-developed action plans to an appropriate and timely resolution.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims;
Manages reserve adequacy throughout the life of the claim.
Manages the litigation process; ensures timely and cost effective claims resolution.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Ensures claim files are properly documented and claims coding is correct.
Requirements
Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Five (5) years of claims management experience or equivalent combination of education and experience required.
Jurisdiction Knowledge: TX, OK, LA.
Licensing: TX or FL.
Benefits
Flexible work schedule.
Referral incentive program.
Opportunity to work in an agile environment.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Job title
Claims Examiner – Workers Compensation, TX, OK, LA
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